Clinical Edge

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PCSK9 Inhibitors and LDL-C Reduction

J Endocrinol Invest; ePub 2019 Feb 14; Dicembrini, et al

Proprotein convertase subtilisin/kexin (PCSK9) inhibitors are effective in reducing low-density lipoprotein cholesterol (LDL-C) and the incidence of major cardiovascular events in high-risk patients, according to a recent review and meta-analysis. All randomized trials (>12 weeks) until December 1, 2017 comparing PCSK9 inhibitors with placebo or active drugs were included. The primary endpoints were 1) LDL-C at endpoint; 2) major CV events (MACE); and 3) all-cause mortality. 38 trials were identified, with mean duration of 36.4 weeks. Researchers found:

  • The reduction of LDL-C at endpoint vs placebo, ezetimibe, and high-dose statins was ‒65.3%, ‒57.7%, and ‒34.5%, respectively.
  • Treatment with PCSK9 inhibitors was associated with a reduction in the incidence of MACE.
  • All-cause mortality and CV mortality were not reduced by treatment with PCSK9 inhibitors.


Dicembrini I, Giannini S, Ragghianti B, Mannucci E, Monami M. Effects of PCSK9 inhibitors on LDL cholesterol, cardiovascular morbidity and all-cause mortality: A systematic review and meta-analysis of randomized controlled trials. [Published online ahead of print February 14, 2019]. J Endocrinol Invest. doi:10.1007/s40618-019-01019-4.